Kev kho mob ntawm ntshav qab zib hom 2 yog ntev thiab yuav tsum tau siv cov tshuaj tshwj xeeb. Kev xaiv cov tshuaj tsis yog tsuas yog nyob ntawm qhov mob hnyav, tab sis kuj yog nyob ntawm tus neeg mob ntawm tus neeg mob, cov yam ntxwv ntawm nws lub cev, muaj cov kab mob ntxiv.
Cov tshuaj Metformin rau ntshav qab zib hom 2 yog ib qho siv tshaj plaws rau ntau xyoo lawm. Qhov no yog qhov keeb kwm ntawm biguanides (ib chav kawm ntawm cov tshuaj lom neeg cov tshuaj lom neeg uas muaj cov nyhuv ntshav qab zib), cov kev kho kom zoo uas ua rau txo cov ntshav qabzib thiab cov txiaj ntsig kho kom zoo. Raws li koj paub, hom ntshav qab zib hom 2 tsis muaj tshuaj insulin. Qhov no txhais tau hais tias muaj ob txoj hauv kev rau nws txoj kev kho - txo cov ntshav qab zib thiab cov tshuaj insulin ntxiv. Kev siv cov metformin rau cov ntshav qab zib tau tso cai rau koj kom tsuas yog tswj cov qib ntawm cov piam thaj. Xav txog lub ntsiab zoo thiab qhov tsis zoo ntawm cov tshuaj no.
Lub hauv paus ntsiab lus ntawm Metformin
Cov tshuaj phiv yog metformin hydrochloride. Los ntawm chav kawm ntawm biguanides, nws tsuas yog tib qho uas muaj kev kho mob zoo.Kev tshuaj xyuas tus neeg mob tau qhia tias cov tshuaj no ua haujlwm zoo dua li lwm qhov hauv nws chav kawm. Qhov no yog vim qhov tseeb tias nws ua nyob rau hauv qib ntawm tes, nce lawv qhov rhiab rau insulin. Ua tsaug rau kev kho mob Metformin, cov teebmeem hauv qab no raug pom:
- daim siab ua haujlwm tawm suab thaj tsawg dua;
- cov roj ntsha ntau dua pib ua rau oxidize;
- cov hlwb ua kev puas tsuaj rau insulin;
- cov piam thaj tsawg dua yog nqus hauv cov hnyuv;
- cov leeg pib haus cov dej qab zib ntau dua;
- ib feem ntawm cov piam thaj thaum kev zom ua rau lactate (lactic acid).
Yog li, cov tshuaj txo cov ntshav qab zib hauv qhov tsis ncaj, vim nws qhov txiaj ntsig tseem ceeb yog ua kom lub cev nkag siab cov tshuaj insulin.
Vim tias qhov tseeb hais tias cov tshuaj ua kom cov nqaij oxidation ntawm fatty acids, muaj cov txiaj ntsig kho ntxiv tshwm sim, nthuav cov pab pawg ntawm cov neeg uas tau pom zoo kom haus cov tshuaj Metformin. Lawv muaj raws li hauv qab no:
- qhov tsim ntawm atherosclerotic vascular plaques nres;
- lub cev hnyav poob, uas zoo cuam tshuam kev kho mob ntawm metabolic syndrome;
- ntshav siab normalizes.
Nws yuav tsum raug sau tseg tias cov txheej txheem ntawm oxidation ntawm fatty acids muaj nyob rau hauv lawv qhov kev rhuav tshem thiab hloov mus rau hauv lub zog. Yog li, cov roj ntsha txuag tau tsawg, lub cev yuav ua neeg yuag dua. Yog li no, cov tshuaj feem ntau siv rau qhov poob phaus, vim tias nws txhawb qhov ncaj qha hlawv cov rog.
Qhov tsis zoo ntawm kev noj cov tshuaj Metformin
Kev siv tshuaj kho mob thiab tshuaj xyuas tus neeg mob qhia tau tias qhov hypoglycemic no muaj kev tsis zoo. Qhov no yog vim tib qho kev nce ntau hauv cov oxidation ntawm lipids. Hauv cov txheej txheem biochemical no, ntau lub zog tsis tsuas yog tsim tawm, tab sis kuj tseem muaj lactate (lactic acid), uas feem ntau ua rau acidosis, uas yog, kev hloov ntawm hydrogen index rau cov kua qaub. Qhov no txhais tau hais tias muaj cov kua qaub ntau nyob rau hauv cov ntshav ntau dua li qhov xav tau, uas ua rau kev ua haujlwm ntawm txhua lub cev thiab cov kab mob ua haujlwm kom tuag.
Cov kab mob lactic acid tuaj yeem tshwm sim ob qho zuj zus thiab tsis poob nthav. Feem ntau nws cov tsos mob yog mob me thiab tsis tseem ceeb, tab sis qee zaus nws los ntawm kev muaj teeb meem thaum lub sijhawm lim ntshav tseem ceeb (uas yog, txuas lub raum cuav rau lub cuab yeej). Cov tsos mob ntawm tus kab mob lactic acidosis muaj raws li hauv qab no:
- cov tsos ntawm tsis muaj zog;
- tsaug zog
- Kiv taub hau
- pa ua tsis taus pa;
- txog siav
- tsis tshua muaj ntshav siab;
- tsawg lub cev kub;
- mob leeg, thiab lwm yam.
Kev kho mob ntawm cov kab mob lactic acid feem ntau yog cov tsos mob, nyob rau qee zaus, hemodialysis yog tus kws kho mob (cov txheej txheem tshwj xeeb rau kev ntxuav ntshav).
Dab tsi yog Metformin siv rau?
Kev siv cov tshuaj yog tswj lub hom 2 mob ntshav qab zib, ntxiv rau kev tiv thaiv tus kab mob no. Cov kws kho mob feem ntau sau ntawv kho ib qho kev tawm tsam kom yuag dhau qhov hnyav, nrawm nrawm, ua kom lub cev metabolism.
Qhov ua kom tsis haum rau siv Metformin
Tus neeg sawv cev rau kev kho mob ntshav qab zib yuav tsum tsis txhob siv rau cov mob hauv qab no:
- thaum cev xeeb tub thiab lactation;
- cov menyuam yaus hnub nyoog qis dua 10 xyoo;
- cov khoom noj uas tsis muaj calorie ntau;
- tom qab cov haujlwm thiab kev raug mob;
- nrog daim siab pathologies;
- nrog rau yav dhau los lactic acidosis;
- yog tias muaj kev ua rau lactic acidosis;
- nyob rau hauv muaj mob raum tsis ua hauj lwm nyob rau hauv lub anamnesis.
Yuav noj cov tshuaj metformin li cas?
Nws yog ib qho tseem ceeb rau cov neeg mob uas xav paub txog kev kho ntshav qabzib ntau hauv cov ntshav kom paub yuav ua li cas noj tshuaj metformin nrog ntshav qab zib. Nws yuav tsum nco ntsoov tias kev ua lag luam muaj cov nyiaj nrog ntau cov tshuaj sib txawv, thaj tsam li 500 mg txog 1000 mg. Kuj tseem muaj cov tshuaj uas muaj lub sijhawm ntev. Qhov tshuaj tiv thaiv thawj zaug tau muab rau hauv qhov ntau kawg, tom qab ntawd tus kws kho mob yuav pom zoo kom nce ntxiv. Tus naj npawb ntawm kev siv ib hnub tseem tuaj yeem muab kho los ntawm tus kws kho mob, tab sis qhov siab tshaj plaws uas tau tso cai rau noj nyob hauv ib hnub twg yog tsis ntau tshaj 2 g
Yuav ua li cas nrog ib tug overdose ntawm cov tshuaj
Tsis txhob nce qhov koob tshuaj ntawm cov tshuaj los txhim kho cov nyhuv ntawm cov tshuaj lossis nce siab kho lub sijhawm. Feem ntau, kev noj ntau dhau ua tiav hauv qhov tsis zoo - nws ua rau muaj kev phom sij rau lub cev, kev tuag taus yuav tsis yooj yim dua.
Qhov phom sij ntawm kev siv ntau tshaj ntawm Metformin yog kev txhim kho ntawm cov kab mob lactic acidosis. Cov yam ntxwv ntawm tus kabmob yog mob plab (uas yog, hauv plab) thiab mob nqaij, muaj teeb meem plab zom mov, ua pa nrawm nrawm, lub cev kub tsawg, kiv taub hau thiab tsis nco qab mus txog thaum tsis nco qab.
Yog tias koj muaj tsawg kawg ntawm ib qho ntawm cov phiajcim no, koj yuav tsum tsum tsis txhob noj tshuaj tam sim ntawd thiab sab laj nrog kws kho mob. Lub tsev khomob yuav siv txhua yam kev coj ua thiaj li yuav tshem tau lactate tawm ntawm lub cev. Nyob rau hauv feem ntau qhov xwm txheej loj, hemodialysis yog kev kho mob. Nws ua tau zoo tshaj plaws thiab muab cov txiaj ntsig tau sai.
Kev cuam tshuam nrog lwm yam tshuaj
Qhov kev tsim txiaj loj no muaj tus yam ntxwv zoo - yuav luag txhua qhov tshuaj hloov tawm los ntawm lub raum tsis hloov, thiab nws seem (li ntawm 10%) ntxiv hauv lub cev. Thiab yog tias lub raum pib ua haujlwm tsis tu ncua, Metformin tsub ntxiv ntau nyob rau hauv cov ntaub so ntswg, uas ua rau muaj kev tsis zoo tshwm sim mus txog rau qhov tsis nco qab.
Nws kuj yog ib qho tseem ceeb heev los kho kom haum rau kev siv cov tshuaj tiv thaiv hypoglycemic nrog insulin. Tom qab tag nrho, yog tias Metformin zoo nkaus li nyob rau hauv cov ntshav ntau tshaj qhov xav tau, tus neeg mob nrog cov lus qhia ntawm insulin tuaj yeem poob rau hauv lub ntsej muag hypoglycemic vim qhov txo qis hauv qabzib muaj ntau.
Kev poob qis hauv cov ntshav hauv lub ntsej muag tseem raug pom nrog kev siv cov tshuaj hauv qab no nrog Metformin:
- sulfonylurea derivatives;
- NSAIDs;
- oxytetracycline;
- MAO inhibitors (cov tshuaj tiv thaiv kev puas tsuaj);
- acarbose;
- ACE inhibitors;
- cyclophosphamide;
- β-blockers
Thiab cov nyiaj no, thaum siv nrog cov tshuaj txo suab thaj, ntawm qhov tsis sib xws, txo nws cov haujlwm:
- corticosteroids;
- cov thyroid hormones;
- tshuaj kho mob;
- estrogens;
- qhov ncauj tiv thaiv;
- nicotinic acid;
- calcium receptor blockers;
- adrenomimetics;
- isoniazids, thiab lwm yam.
Yog li, Metformin yog ib cov tshuaj muaj suab thaj zoo heev uas muaj qhov ua tau siab, tab sis tib lub sij hawm tsis yog ib qho tshuaj uas suav daws. Nws muaj nws qhov tsis zoo thiab tsis pom kev. Lawv feem ntau muaj hnub nyoog me thiab dhau mus li ntawm 1-2 lub lis piam, tab sis lwm tus yuav yuam kom tsum tsis txhob noj.
Txhawm rau cov tshuaj kom ua haujlwm zoo, nws yuav tsum koom tes nrog kev noj tshuaj nrog tus kws kho mob, ua raws txhua yam nws pom zoo, nruj me ntsis rau cov khoom noj kom zoo thiab ua tib zoo saib xyuas contraindications thiab nws cov kev mob tshwm sim. Koj tseem yuav tsum nco ntsoov tias haus cawv yog yeeb ncuab tseem ceeb ntawm Metformin, yog li cov dej cawv muaj cawv yuav tsum tau cais tawm thaum kho. Qhov no yog vim qhov tseeb tias cawv txwv tsis pub ua haujlwm ntawm ntau lub siab enzymes. Yog li, ntau Metformin nkag mus rau hauv cov hlab ntshav, uas ua rau cov ntshav qabzib nce siab txog cov ntshav qabzib. Ib qho ntxiv, haus dej cawv thaum sib cuam tshuam nrog cov tshuaj lactic acid. Yog li, nws txoj kev siv thaum kho nrog cov tshuaj no yog contraindicated.
